冠心病血清胰岛素浓度与心率变异性的变化及其关系

CHANGES OF AND RELATIONSHIPS BETWEEN SERUM INSULIN LEVELS AND HEART RATE VARIABILITY IN PATIENTS WITH CHD

检测冠心病３４例，对照组３０例糖耐量前后血糖、胰岛素、Ｃ肽的变化，并测定２４小时动态心电图心率变异性（ＨＲＶ）。结果冠心病组空腹与服糖后胰岛素、Ｃ肽均明显升高，ＨＲＶ显著下降。进行血糖、胰岛素、Ｃ肽同ＨＲＶ相关分析，仅显示服糖后２小时胰岛素和胰岛素曲线下面积与ＨＲＶ呈负相关，ＨＲＶ≤１００ｍｓ的冠心病组显示更高的胰岛素水平，提示高胰岛素血症的交感神经兴奋作用可能是冠心病患者ＨＲＶ降低的原因之一。

Blood glucose(BG),insulin(IS)and C-peptide(CP)levels during OGTT was measured in 34 patients with CHD and 30 control subjects.Heart rate variability(HRV)was evaluated by 24-h ambulatory electrocardiogram.The results showed that significantly higher serum IS and CP levels of fasting and oral glucose load appeared in CHD patients compared with control group,but lower HRV.Negative correlatins were found between 2-h IS and HRV in CHD group,as well as between area under the curve of serum IS and HRV.The patients with lower HRV(≤100 ms)showed higher IS concentration.The results indicated that increased sympathetic nervous activity in hyperinsulinemia may be a cause of decreased HRV in patients with CHD.